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Changes in tooth size-arch length relationships from the deciduous to the permanent dentition: a longitudinal study.

The purpose of this investigation is to determine the changes in the maxillary and mandibular tooth size-arch length relationship (TSALD) after the complete eruption of the deciduous dentition (mean age = 4.0 years) to the time of eruption of the second molars (mean age = 13.3 years). In addition, an attempt was made to determine whether TSALD in the permanent dentition can be predicted in the deciduous dentition. Records on 35 male and 27 female subjects were evaluated. Each subject had a clinically acceptable occlusion--that is, a normal molar and canine relationship, at the time of eruption of the deciduous and permanent teeth. In addition, each subject had a complete set of data at the two stages of dental development. These selection criteria limited the number of subjects in this investigation to 62. The mesiodistal diameter of all deciduous teeth and their permanent successors, as well as various dental arch width and length parameters, were measured in the deciduous and permanent dentitions. A total of 68 parameters were measured or calculated. Student t tests were used to determine whether significant differences were present between the right and left sides for both male and female subjects. Correlation coefficients r were performed between the deciduous and the corresponding permanent teeth and also for the arch length parameters, as well as TSALD in the two dentitions. Significance was predetermined at the 0.05 level of confidence. Stepwise regression analysis (R2) was used to determine which of the variables in the deciduous dentition could be included in a regression model to determine associations between maxillary and mandibular TSALD in the permanent dentition.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

A retrospective comparison of functional appliance treatment of Class III malocclusions in the deciduous and mixed dentitions.

This retrospective study compared the effectiveness of treatment of Class III malocclusions with the removable mandibular retractor in the deciduous and mixed dentitions. A group of 20 children with Class III malocclusions started treatment at a mean age of 5 years 1 month +/- 7 months (deciduous dentition), while a group of 18 children with Class III malocclusions started treatment at a mean age of 8 years 2 months +/- 9 months (mixed dentition). The mean observation period was 2 years 3 months +/- 6 months for the first group, and 2 years 4 months +/- 7 months for the second group. Matched control groups of children with untreated Class III malocclusions in the deciduous and in the mixed dentition (16 subjects and 15 subjects, respectively) were used. The cephalometric analysis was based on a stable basicranial reference system appropriate for longitudinal studies that begin at early developmental ages. The results showed that treatment of Class III malocclusions in the deciduous dentition produced a more significant anterior morphogenetic rotation of the mandible, due to a more upward and forward direction of condylar growth (P < 0.01). This leads to significantly smaller increments in mandibular total length (Co-Pg) in children with Class III malocclusions under-going very early treatment (P < 0.01). On the contrary, maxillary dento-alveolar protrusion induced by therapy was greater in Class III subjects treated in the mixed dentition (P < 0.01). The optimum timing to improve skeletal relationships in Class III malocclusions by means of a functional appliance appears to be in the deciduous dentition.

Age Factors↗

Tightness of dental contact points in spaced and non-spaced permanent dentitions.

One of the characteristics of normal occlusion is tight dental contact points (CPs). However, the magnitude and distribution of the tightness of a dental contact point (TDCP) in non-spaced versus spaced dentitions are unknown, as well as the mechanism controlling this arrangement. Two hypotheses were examined: the compression theory, i.e. the teeth touch each other in a compressive state; and the resistance theory, i.e. size and number of roots determine TDCP values. For the study, 60 subjects (27 men, 33 women), mean age 25 +/- 4.3 years, with a complete permanent dentition and no missing teeth were divided into spaced (n = 22) and non-spaced dentitions (n = 38). For each CP, four repeated measurements of peak strain were performed with a one-month interval. No significant differences were found between repeated measurements. All CPs demonstrated a continuous decreased TDCP in the postero-anterior direction. Consequently, in non-spaced dentitions TDCPs between molars were 100 per cent higher than incisors. The five anterior CPs of each jaw demonstrated similar TDCP values. Maxillary TDCPs versus mandibular antagonists were not significant. Mandibular TDCPs were significantly higher in men than in women (14 per cent). Anterior TDCPs were less in spaced than in non-spaced dentitions (55 per cent). Posterior TDCPs were also lower in spaced dentitions, however, to a lesser extent (25 per cent). With the exception of TDCPnon-spaced > TDCPspaced, which is partially explained by the compression theory, most of the findings support the resistance theory regulating TDCP characteristics of the permanent dentition.

Adult↗

Cephalometric standards for Slovenians in the mixed dentition period.

The aim of this study was to develop standard cephalometric values for Slovenians in the period of the mixed dentition. Eighty-eight children were included in the study (46 girls and 42 boys, mean age 9.31 +/- 1.52 years). The selection criteria were: in the mixed dentition, a score of the modified Eismann method for an objective assessment of malocclusion of less than 15 points, the absence of aplasia and supernumerary teeth, no congential anomalies and no previous orthodontic treatment. Twenty-five cephalometric measurements were performed twice to analyse the size and shape of the craniofacial complex. The reliability of the measurements was assessed by correlation coefficients, regression, and analysis of inter-subject differences; satisfactory results were obtained. The differences between boys and girls and between those in the early and late mixed dentition period were tested with a two-way analysis of variance. The most pronounced changes between the early and late mixed dentition were observed in the vertical skeletal relationships: a decrease in mandibular inclination, interbasal angle and gonial angle, and an increase in anterior and posterior face height. Sagittal skeletal relationships remained constant from the early to the late mixed dentition. No significant differences were found between the observed developmental stages. Significant differences between genders were found only for anterior and posterior face height, with boys showing larger values (P </= 0.001). As there were no significant differences between the early and late mixed dentition, the mean measurement values of the total sample can be used as cephalometric standards for Slovenians in the mixed dentition period.

Age Determination by Teeth↗

Comparison of two methods of space prediction in the mixed dentition.

PURPOSE: This study compares the accuracy of space prediction for the unerupted permanent canines and premolars by a recognized method of mixed dentition space analysis (Moyers technique) vs estimation by simple visual observation (SVO). METHODS: Twenty clinicians with varying levels of dental experience and training blindly assessed study models of 4 intact arches (2 maxillary and 2 mandibular) from 3 patients in the mixed dentition using both Moyers and SVO space prediction methods. Corresponding full-mouth panoramic radiographs were available for each case. Follow-up records of the eventual outcome in the permanent dentition for each case available (ie, study models prior to any form of orthodontic intervention) served as the standard for further comparison of the space predictions made. Predictions by both methods were compared with each other as well as with the eventual space situation in the permanent dentition. RESULTS: The differences in overall mean space prediction between the Moyers technique (excluding molar shift) and SVO ranged between 3.67 mm to 6.9 mm (lower arches) and 4.3 mm to 4.8 mm (upper arches). Diagnostic consistency between both methods' predictions was highly variable, with correlation ranging from moderate (r = 0.53, P = .01) to very weak (r = -0.1). Generally, more crowding was estimated with the SVO method's predictions. However, the inclusion of molar shift in the Moyers analysis resulted in the prediction of more crowding in the mandible compared to SVO and eventual outcome in the permanent dentition. The range and variability in predictions were always smaller with the Moyers technique compared to SVO. Neither technique's mean space prediction more closely resembled the eventual space situation in the permanent dentition. CONCLUSIONS: This study demonstrated that although the Moyers technique demonstrated less variation and more reproducibility than SVO in its space predictions, neither of the techniques was any more accurate in predicting the final space outcome in the permanent dentition.

Analysis of Variance↗

[A longitudinal study on growth and development of dental arches of primary, mixed and permanent dentitions].

In dental clinic for children, criteria for growth and developmental changes related to increases in the width and length of the dental arch at the primary, mixed, and permanent dentition stages are essential. This study was carried out to measure the width and the length of normal dental arch and to make detailed observations of growth and developmental processes in the dental arch at each dentition stage. Materials were serial study casts of the maxilla and the mandible taken every 2 month from 127 children (74 boys and 54 girls). The casts were made from 6 months after birth until the age of 15. Measurements of the width of the dental arch were made between bilateral teeth of the same tooth type, both deciduous and permanent. The length of the dental arch was measured on the basis of the perpendicular distance from the contact point of mesial surfaces of central incisors to a line between bilateral teeth of the same tooth type. Measured values were categorized according to either chronological age or tooth age on the basis of the eruption of the central permanent incisors. The indices of the dental arch with relation to the width and the length at each dentition stage were calculated for the sake of partial and total observations of alterations in dental arch form. The results were as follows: 1) In terms of chronological age, until 1 year before the eruption of permanent replacements, the width of the dental arch gradually decreased in both the maxilla and the mandible in the regions of the deciduous central and lateral incisors. Increasing slightly from about the age of 6 years and the period of mixed dentition, the width of the dental arch remained stable until the permanent dentition stage. From the primary dentition stage, the width of the dental arch in the region of the maxillary and mandibular canines and first and second molars gradually increased. Therefore it remained stable until the eruption of permanent dentition. The width in the region of the permanent maxillary and mandibular first molars gradually increased and attained a stable condition at about 12 years of age. In males, the width in the area of the maxillary secondary molars decreased slightly and tended to decrease in the mandible. In females, on the other hand, the width showed a tendency to increase with advancing ages. With the exception of the second permanent molars, the width between the distance of bilateral teeth were consistently larger in males than in females.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Origin and evolution of gnathostome dentitions: a question of teeth and pharyngeal denticles in placoderms.

The fossil group Placodermi is the most phylogenetically basal of the clade of jawed vertebrates but lacks a marginal dentition comparable to that of the dentate Chondrichthyes, Acanthodii and Osteichthyes (crown-group Gnathostomata). The teeth of crown-group gnathostomes are part of an ordered dentition replaced from, and patterned by, a dental lamina, exemplified by the elasmobranch model. A dentition recognised by these criteria has been previously judged absent in placoderms, based on structural evidence such as absence of tooth whorls and typical vertebrate dentine. However, evidence for regulated tooth addition in a precise spatiotemporal order can be observed in placoderms, but significantly, only within the group Arthrodira. In these fossils, as in other jawed vertebrates with statodont, non-replacing dentitions, new teeth are added at the ends of rows below the bite, but in line with biting edges of the dentition. The pattern is different on each gnathal bone and probably arises from single odontogenic primordia on each, but tooth rows are arranged in a distinctive placoderm pattern. New teeth are made of regular dentine comparable to that of crown-gnathostomes, formed from a pulp cavity. This differs from semidentine previously described for placoderm gnathalia, a type present in the external dermal tubercles. The Arthrodira is a derived taxon within the Placodermi, hence origin of teeth in placoderms occurs late in the phylogeny and teeth are convergently derived, relative to those of other jawed vertebrates. More basal placoderm taxa adopted other strategies for providing biting surfaces and these vary substantially, but include addition of denticles to the growing gnathal plates, at the margins of pre-existing denticle patches. These alternative strategies and apparent absence of regular dentine have led to previous interpretations that teeth were entirely absent from the placoderm dentition. A consensus view emerged that a dentition, as developed within a dental lamina, is a synapomorphy characterising the clade of crown-group gnathostomes. Recent comparisons between sets of denticle whorls in the pharyngeal region of the jawless fish Loganellia scotica (Thelodonti) and those in sharks suggest homology of these denticle sets on gill arches. Although the placoderm pharyngeal region appears to lack denticles (placoderm gill arches are poorly known), the posterior wall of the pharyngeal cavity, formed by a bony flange termed the postbranchial lamina, is covered in rows of patterned denticle arrays. These arrays differ significantly, both in morphology and arrangement, from those of the denticles located externally on the head and trunkshield plates. Denticles in these arrays are homologous to denticles associated with the gill arches in other crown-gnathostomes, with pattern similarities for order and position of pharyngeal denticles. From their location in the pharynx these are inferred to be under the influence of a cell lineage from endoderm, rather than ectoderm. Tooth sets and tooth whorls in crown-group gnathostomes are suggested to derive from the pharyngeal denticle whorls, at least in sharks, with the patterning mechanisms co-opted to the oral cavity. A comparable co-option is suggested for the Placodermi.

Animals↗

Conserved developmental processes constrain evolution of lungfish dentitions.

Although the 3 genera of living lungfish have different-shaped adult tooth plates, their larval stages have similar patterns of development. The sequence in the pattern of initiation of teeth and their modification through ontogeny in Neoceratodus hatchlings provides a developmental model for fossil hatchling tooth plates (smallest 1-2 mm) recovered as 3-dimensional dentitions from Andreyevichthys. This Late Devonian lungfish demonstrates that these also have a similar dentition pattern and suggests strongly conserved developmental processes. We postulate that a specific pattern of development, derived within lungfish, has been conserved in extant forms through evolution from the earliest known lungfish. The most basal early dipnoan, Diabolepis speratus, is also known from juveniles with tooth plates formed in this pattern. The lungfish pattern is in marked contrast to the typical linear rows of teeth with lingual replacement for each tooth position, characteristic of most osteichthyan and chondrichthyan dentitions. Uniquely for lungfish, teeth are only added to the lateral ends of the radial rows in the palatal and lingual dentition and are consolidated into dental plates without loss through shedding. It is proposed that this tooth pattern is set up from primordial teeth at the patterning stage of the dentition, one in each dentate region of the larval jaws. Although in post-Devonian lungfish marginal dentate bones are absent in the adult, in both the fossil and extant hatchling, teeth are present and function on some of the marginal bones. This pattern of development and loss is described and we conclude that in both forms it is also based on a radial pattern of successive tooth initiation. We propose that this ontogenetic pattern constrained the phylogenetic pattern of adult form, through evolution of dipnoan dentitions from 360 MYBP until the present. The universality amongst dipnoans and the implications for such a conserved constraint in the developmental module for the dentition is discussed.

Animals↗

Gingivitis in the deciduous and permanent dentition. An experimental study in the dog.

The present investigation was performed in order to study the reaction of the gingiva in the deciduous and permanent dentition of dogs to 3 weeks of plaque accumulation. The study was carried out in 10 beagles, divided into 2 groups of 5 dogs each; group I and group II. When the dogs of group I were 10 weeks old, a meticulous plaque control regimen was initiated in order to establish clinically healthy gingiva. After 6 weeks of plaque control, the gingivae of the lower deciduous molars was exposed to a clinical examination, and biopsies as well as bacterial plaque samples were harvested from tooth 03P and 02P. A second plaque control regimen was initiated when the same dogs were 15 months old. After 6 weeks of plaque control, the gingiva of the permanent dentition was examined and biopsies sampled from tooth P3 and P4. In the dogs of group II, plaque control regimens of 3 weeks duration were initiated when the animals were 10 weeks and 15 months old. Clinical examinations were performed at the end of each 3-week period. Immediately after the clinical examinations. 3-week periods of plaque accumulation were initiated. Examinations and plaque sampling were performed after each of these 3-week periods and biopsies were sampled from the deciduous and permanent dentition as described for group I. The biopsies were processed for histometric and morphometric measurements. The findings from the experiment showed that careful plaque control resulted in the establishment of clinically healthy gingiva. In both the deciduous and permanent dentition, however, a clinically healthy gingiva was found to contain a small inflammatory cell infiltrate (ICT). 3 weeks of plaque accumulation resulted in both dentitions in the development of clinical signs of gingivitis and in the formation of comparatively large ICT. The large ICT of the permanent gingiva resided in the coronal portion of the free gingival unit, while in the deciduous dentition, the inflammatory lesion occupied a narrow tissue portion along the entire border of the dento-gingival epithelium. The ICT of the permanent gingiva harbored a larger portion of plasma cells than the inflammatory lesion studied in the deciduous dentition.

Animals↗

[Investigation into the actual condition of patients with occlusal disharmony at the Pedodontic Clinic of Kyushu University. Cases of anterior cross-bite in the deciduous dentition].

The total number of subjects was 2754 children (1354 boys and 1402 girls), who visited the Pedodontic Clinic of Kyushu University during the 5 year period from April 1st 1981 to March 31st 1986. We investigated the actual conditions of patients who complained of occlusal disharmony and who were ascertained to be associated with occlusal disharmony. The results were as follows: 1. The percentage ratio of patients with chief complaints concerning occlusions was 14.5% and the percentage of patients with various type of complaints as well as the problem of occlusion was 8.1%. The ratio of the sex of the patients who complained of their occlusal disharmony was 43.0% for boys and 57.0% for girls. 2. The age distributions of the patients who had as the chief complaint occlusal disharmony were at the ages of 3 and 6 to 7 at the maximum. 3. The number of patients who were diagnosed with occlusal disharmony at the first examination was 28.5%. These included anterior cross-bite 32.5%, edge to edge bite 14.1%, cross-bite 13.0%, crowding 11.8% and et al. 4. The distribution of anterior cross-bites due to the developmental stage was divided into the deciduous dentition 59.9%, the mixed dentition 39.3% and the permanent dentition 0.8%. 5. The sex ratios of anterior cross-bites in the deciduous dentition were 45.6% for boys and 54.4% for girls. 6. The treatment of occlusal guidance for anterior cross-bite in the deciduous dentition started from ages 3 to 5. 7. The appliances used for the treatment of anterior cross-bite in the deciduous dentition were maxillary protraction 25.0%, the chin cap 20.0%, the FKO 17.5%, and the lingual arch with herical springs 15.0% and et al. 8. The status of the patients with the anterior cross-bite in the deciduous dentition as of August 1986 was that the 36.2% was under the observation, and 24.4% was under the treatment of occlusal guidance or under the observation after the treatment was done.

Child↗

Molar distalization with pendulum appliances in the mixed dentition: effects on the position of unerupted canines and premolars.

INTRODUCTION: The pendulum appliance allows for rapid molar distalization without the need for patient compliance. Its efficiency has been confirmed in a number of clinical studies. However, the potential interactions and positional changes between the deciduous molars used for dental anchorage and the erupted and unerupted permanent teeth have yet to be clarified when this appliance is used for molar distalization in the mixed dentition. METHODS: Twenty-nine patients in the mixed dentition each received a modified pendulum appliance with a distal screw and a preactivated pendulum spring for bilateral distalization of the maxillary molars. The patients were divided into 4 groups based on dentition stages: patient group 1 (PG 1, n = 10) was in the early mixed dentition; patients had resorption of the distal root areas of the deciduous molars being used for dental anchorage, and the unerupted premolars were located at the distal margin of the deciduous molar root region. Based on radiographs taken before placement of the pendulum appliance, patient group 2 (PG 2, n = 10) was diagnosed as having a central location of the unerupted premolars. In the third group (PG 3, n = 4), the first premolars were already erupted and could be integrated into the dental anchorage, but the canines were not yet erupted. In the fourth group (PG 4, n = 5), the first premolars and both canines were fully erupted. RESULTS: Statistical analysis of the measured results showed significant differences in the side effects between PG 1 and PG 2. In patients being treated with pendulum appliances, the anchorage quality of the deciduous molars that were already partially resorbed in the distal root area was comparatively reduced. Consequently, the mesial drift of the deciduous molars and incisors was increased, without impairing the extent and quality of the molar distalization. Anchorage loss in the supporting area had no direct impact on the sagittal position of the unerupted premolars in the early mixed dentition. CONCLUSIONS: If permanent teeth have already started to erupt in the supporting area, additional space restrictions should be avoided in patients with critical topography, especially if there is little space for the unerupted canines. At this stage of the mixed dentition, premolar extraction or augmentation of the supporting area with extraoral headgear offers a therapeutic alternative to intraoral distalization appliances with exclusively dental anchorage.

Analysis of Variance↗

The compensatory mechanism in high-angle malocclusions: a comparison of subjects in the mixed and permanent dentition.

Dentoskeletal morphology was assessed in 191 untreated and unselected children with a hyperdivergent (high-angle) mandibular plane (ML/NSL > or =40 degrees) by analyzing lateral roentgenographic cephalograms. The subjects were divided into mixed dentition and permanent dentition groups, and further divided into subgroups based on the amount of overbite (OB) as a measure of dentoalveolar compensation of jaw base hyperdivergency: OB < 0 mm (openbite) = insufficient/no compensation; OB 0 to 4 mm (normal overbite) = acceptable compensation; OB > 4 mm (deepbite) = overcompensation. Openbite was observed in 20% of the children, normal overbite in 50%, and deepbite in 30%. Skeletally, the deepbite mixed dentition group was characterized by a relatively posterior inclination of the maxilla, while the deepbite permanent dentition group had a relatively anterior inclination of the mandible. Dentoalveolar compensation was accomplished by relative increases in maxillary and mandibular anterior dentoalveolar heights in the mixed dentition group and by relative decreases in maxillary and mandibular posterior dentoalveolar heights in the permanent dentition. Positive overbite was found in the majority (80%) of children with high-angle morphology. Thus, mandibular hyperdivergency is frequently compensated for. Skeletal characteristics and dentoalveolar compensatory mechanisms differ with dental maturity and seem to be influenced by mouth breathing and other oral habits.

Age Factors↗

The relationship between occlusal factors and bruxism in permanent and mixed dentition in Turkish children.

The aim of this study was to investigate the relationship between occlusal factors (overjet, overbite, Angle's Classification of molars and cuspids, the relationship of the primary molars, openbite, lateral openbite, scissorbite and crossbite) and bruxism in permanent and mixed dentition in Turkish children. For this reason 182 children with mixed dentition and 212 children with permanent dentition were included in this study. Occlusal conditions were examined clinically and bruxism was assessed by using interview and questionnaires. Z Test was used to compare the results. It was found that in both dentitions some occlusal factors related with bruxism (overjet > 6 mm, overbite > 5 mm, negative overjet, openbite in permanent dentition; overjet > 6 mm, overbite > 5 mm, scissorbite, anterior-posterior multiple teeth crossbite, Angle Class I occlusion in mixed dentition.

Adolescent↗

Combined therapy with pendulum and lingual arch appliances in the early mixed dentition.

PATIENTS AND METHOD: In 20 patients with arch length deficiency and anterior crowding, pendulum and lingual arch appliances were inserted simultaneously in the upper and in the lower arch respectively to gain space. The patients were divided into two groups according to their dental eruption stage: ten children (six boys, four girls; mean age: 9 years, 6 months) were in the early mixed dentition, while an adolescent comparison group of the same size (three boys, seven girls; mean age: 12 years, 3 months) were in the permanent dentition at the beginning of treatment. AIM: The main purpose of the study was to investigate whether simultaneous therapy with pendulum and lingual arch appliances is to be recommended, i.e. whether this therapy should take place as interceptive treatment in the early mixed dentition or only in the permanent dentition in adolescence. Parameters were the extent and quality of dentoalveolar effects and the side effects (mesial movement of the incisors, protrusion of the incisors, tipping of molars). RESULTS: The treatment course was documented by means of study casts and lateral cephalograms. Assessment of the diagnostic records yielded the following findings: In the early treatment group the maxillary molars were distalized by the pendulum appliance by a mean distance of 4.0 +/- 1.46 mm, resulting in distal tipping by 6.1 +/- 2.18 degrees. The incisors were moved reciprocally by 1.08 +/- 1.06 mm to anterior and protruded by 7.65 +/- 4.84 degrees. In the comparison group molar distalization and molar tipping were less pronounced (2.86 +/- 1.54 mm/4.25 +/- 3.78 degrees ), while mesial movement of the incisors was comparably high at 1.62 +/- 0.99 mm. At only 3.8 +/- 2.9 degrees, incisor protrusion was significantly less pronounced than in the early treatment group (p = 0.045). The proportion of molar distalization in the total movement was higher in patients in the early mixed dentition: 79.83 +/- 15.38% vs 60.71 +/- 26.64%. During the early therapy with the lingual arch appliance in the lower arch, the molars were uprighted to the distal by 2.4 +/- 0.97 degrees and the incisors were tipped to labial by 5.0 +/- 1.83 degrees. In the adolescent control group, molar uprighting was less pronounced and the degree of incisor protrusion was significantly lower (2.75 +/- 1.11 degrees, p = 0.004). CONCLUSION: With the appropriate indication, the combined therapy with the two compliance-independent appliances described can be recommended for gaining sagittal arch length in the early mixed dentition.

Cephalometry↗

Longitudinal dental arch changes in the mixed dentition.

The purpose of this study was to investigate dental arch changes that occurred during the mixed dentition in 30 normal occlusion children. Two analyses were done. The first one was at the age of early mixed dentition and the second at the age of late mixed dentition. Most width variables were greater in the males, and depth variables greater in the female subjects. A directionally larger left side of the maxilla and right side of the mandible were observed. Our findings indicate that most arch width dimensions are established in the early mixed dentition. We conclude that the period between the early and late mixed dentition is suitable for environmental factors to disrupt the ideal symmetrical developmental pattern because more growth and developmental changes occur after a relatively stabile period of deciduous dentition.

Adolescent↗

Condylar motion in children with primary dentition during lateral excursion.

Normal development of primary and mixed dentition is indispensable for establishing a healthy mandibular function of the permanent dentition. Because condylar movements are crucial for mandibular function, extensive studies have been reported. However, most of these studies have dealt with mandibular functions in adults, and there is less known about children with primary dentition. The purpose of this study was to clarify the condylar movements during lateral excursions in children with primary dentition and compare these movements with those of adults from the viewpoint of functional development. With use of an optoelectronic recording system with six degrees of freedom, the lateral excursions of 24 children and 20 young women, with sound dentition, were recorded at 100 Hz. The results show that the balancing side condyle of the children had a significantly smaller vertical excursion and a significantly larger anteroposterior excursion than that of adults, indicating the shallower and more anteriorly directed movements of the entire mandible during lateral excursions in children with primary dentition.

Adult↗

Inflammatory mediators of the terminal dentition in adult and early onset periodontitis.

Based upon the prosthodontic literature, subjects who are at the transition stage between natural dentition and edentulism are called "terminal dentition" (TD) cases. The aim of the present cross-sectional investigation was to characterize the local and systemic inflammatory responses in 2 groups of patients with terminal dentition periodontitis. Eight severe adult periodontitis terminal dentition (AP-TD) subjects and 8 early onset periodontitis terminal dentition (EOP-TD) subjects were entered into the study. Our purpose was to measure an extended battery of cytokines in the gingival crevicular fluid (GCF) and in lipopolysaccharide (LPS)-stimulated monocytic culture supernatants as well as gingival mononuclear cell messenger RNA (mRNA) transcripts determined from biopsy samples. Within the GCF there were 3 tiers (levels) of mediators based upon approximate 10-fold differences in concentration. The highest tier included prostaglandin E2 (PGE2), interleukin-1 beta (IL-1 beta) and interleukin-2 (IL-2), the intermediate tier included tumor necrosis factor alpha (TNF alpha) and interferon gamma (IFN-gamma) and at the lowest concentration level were interleukin-4 (IL-4) and interleukin-6 (IL-6). Thus, the GCF analysis clearly indicated that in both AP-TD and EOP-TD groups the monocytic, i.e. IL-1 beta and PGE2 and Th1, i.e. IL-2 and IFN-gamma, inflammatory mediator levels quantitatively dominated over the Th2 mediators, i.e. IL-4 and IL-6. LPS-stimulated monocytic release of IL-1 beta, PGE2 and TNF alpha was significantly elevated in both AP-TD and EOP-TD groups compared to those of a control group of 21 subjects with moderate to advanced adult periodontitis. The cytokine mRNA expression of isolated gingival mononuclear cells showed that in both the AP-TD and the EOP-TD groups Th1 and Th2 cytokines were expressed, with low levels of IL-4 and IL-12. In conclusion, our data suggest that this cross-sectional TD periodontitis model may reflect progressive periodontal disease associated with tooth loss. Furthermore, although Th1 cytokine levels in the GCF dominate over the Th2 response, monocytic activation provides the main source of proinflammatory mediators. In addition, LPS-stimulated peripheral blood monocytes demonstrate an upregulated inflammatory mediator secretion in the terminal dentition.

Adult↗

Are severe occlusal problems more frequent in permanent than deciduous dentition?

OBJECTIVE: To determine the prevalence and severity of occlusal problems in populations at the ages of deciduous and permanent dentition and to carry out a meta-analysis to estimate the weighted odds ratio for occlusal problems comparing both groups. METHODS: Data of a probabilistic sample (n=985) of schoolchildren aged 5 and 12 from an epidemiological study in the municipality of São Paulo, Brazil, were analyzed using univariate logistic regression (MLR). Results of cross-sectional study data published in the last 70 years were examined in the meta-analysis. RESULTS: The prevalence of occlusal problems increased from 49.0% (95% CI =47.4%-50.6%) in the deciduous dentition to 71.3% (95% CI =70.3%-72.3%) in the permanent dentition (p<0.001). Dentition was the only variable significantly associated to the severity of malocclusion (OR=1.87; 95% CI =1.43-2.45; p<0.001). The variables sex, type of school and ethnic group were not significant. The meta-analysis showed that a weighted OR of 1.95 (1.91; 1.98) when compared the second dentition period with deciduous and mixed dentition. CONCLUSIONS: In planning oral health services, some activities are indicated to reduce the proportion of moderate/severe malocclusion to levels that are socially more acceptable and economically sustainable.

Adolescent↗